Efficacy And Safety Of Pancreatin In Patients With Pancreatic Exocrine Insufficiency Due To Chronic Pancreatitis: A Meta-Analysis

Objective: To assess the efficacy and safety of pancreatins on chronic pancreatitis patients with pancreatic exocrine insufficiency(Cp PEI)by a meta-analysis.Methods: The randomized controlled trials(RCTs)about the efficacy and safety of pancreatins on Cp PEI patients were searched by databases(published up to December 1,2016).Studies meeting all the criteria were included.The data were extracted and the research bias evaluated.The outcomes were coefficient of fat absorption(CFA),coefficient of nitrogen absorption(CNA),faecal fat excretion(FFE),faecal nitrogen excretion(FNE),faecal weight and treatment-emergent adverse events(TEAEs).Results: Of 7 RCTs included in this meta-analysis with a total of 292 Cp PEI patients,5 RCTs were about the efficacy and safety of pancreatins versus placebo,and another one about of different doses of pancreatins in Cp PEI.The coefficient of fat absorption in Cp PEI patients was significantly improved after treatment of pancreatins[SMD=2.43,95%CI(1.35~3.50),P<0.00001],which was superior to placebo[SMD=2.83,95%CI(1.37~4.28),P=0.0001].And the coefficient of nitrogen absorption,faecal fat excretion,faecal nitrogen excretion and faecal weight were also significantly improved.However,the coefficient of fat absorption[SMD=0.08,95%CI(-0.21~0.36),P=0.60],coefficient of nitrogen absorption[SMD=0.13,95%CI(-0.19~0.45),P=0.43] and faecal fat excretion[SMD=-0.09,95%CI(-0.38~0.19),P=0.52] in a higher therapeutic doses of pancreatin were similar with those in a lower ones.The adverse events of pancreatins were similar to placebo[SMD=1.10,95%CI(0.52~2.32),P=0.81].Conclusion: This results suggested that pancreatins can improve the digestion and absorption function in Cp PEI patients,and have no serious adverse reactions.